Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Version, Fetal”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed1994

[Effect of ultrasound examination on fetal version of breech presentation].

External version was attempted in 70 pregnancies with foetuses in breech presentation near term. Version was successful in 50 patients (71%), 40 of whom delivered vaginally (80%). Of the 20 patients in whom version was not successful, only 7 patients (35%) delivered vaginally. 2 patients required immediate Caesarean section after attempted version because of ominous foetal heart rate patterns. We analysed the sonographic parameters associated with successful version. The location of the placenta, amount of amniotic fluid, foetal biometry (estimated foetal weight, cephalic circumference, abdominal diameter, femur length) and extension or flexion of the foetal head were analysed. Only extended legs correlated with the success of the procedure. The results suggest, that ultrasonography is an important prerequisite for successful version of a foetus in breech presentation near term.

Adult↗
PubMed1993

[External fetal version from breech to vertex presentation. Evaluation of 1,000 cases].

Results of 1000 external versions of foetuses from breech to vertex presentation under tocolysis were evaluated. The rate of success of the versions was 52%. The success rate improved with gestational age, with increasing parity, with increasing age of the mother and her increasing body weight. The location of the placenta did not play a decisive role. The success rate of the version was remarkably good, even, in cases with small-for-gestational age foetuses and large-for-gestational age foetuses as well as in cases with a previous Caesarean section. The frequency of typical complications and the resulting Caesarean rate of 2.3% are within the acceptable limit. Up to now, from a total of more than 1,500 versions performed at the Department of Obstetrics at the Women's Hospital, Berlin-Neukölln, no death of either mother or child has occurred, which could be related to this procedure. Of course, the prerequisite for a safe version is strict adherence to the essential guidelines. The fact, that versions are not practised in all obstetrical departments, is partly due to the embarrassing lack of expert knowledge on the part of some practitioners and clinicians. In numerous cases, a moderately difficult laparotomy--which Caesarean section is in principle--with all the inevitable risks and dangers, could have been prevented, if a version had been performed.

Adult↗
PubMedDate not supplied

[Influences on decisions of pregnant patients with breech presentation for external fetal version or cesarean section--information status and anxiety pattern].

Within the framework of a retrospective and prospective analysis of 61 women with breech presentation in late pregnancy and with the help of a half-standardised questionnaire, we investigated the subjective reaction of these patients after they had been informed of their situation, as to what fears resulted and how well informed they were regarding the various obstetrical procedures in cases with breech presentation. The patients in the version group were clearly more anxious (n = 41). They were frightened of putting the child's well-being at risk, damaging personal health and having a cesarean section. The fear patterns were very varied in both groups. In the cesarean group (n = 20) the patients were not so afraid of the anesthesia and the risk of infection, whereas those in the version group were considerably more afraid; it was quite the reverse as regards the risk of permanent damage to the child due to the version--in the cesarean group this was rated as a high risk, whereas in the version group it was rated as a slight risk. The decision on the obstetrical procedure was mainly influenced by the doctor. In conclusion it can be said, that too little is known about the obstetrical procedure of cephalic version near to term and that it is tainted with unnecessary fears. We recommend that more intensive, specialised information should be given before undertaking obstetrical management of breech presentation.

Adult↗
PubMed1997

[Criteria for successful outcome of external fetal version from breech presentation to cephalic presentation].

The technique of external version of breech presentations has been proposed as a tool to reduce morbidity of fetus and mother. 79 cases of a 3 year period were evaluated aiming at identification of risk factors improving the success rate of the intervention. A total of 48% of attempts was successful. The most frustrating single factor was identified to be the oligohydramnion. Posterior implantation of the placenta improved the rate to 61%. The umbilical cord being localized by coloured Doppler had little influence even if positioned around the neck as neither success nor complications were predictable in this case. Maternal adipositas had a negative influence on the success rate. Perinatal morbidity war not increased in the group of external versions.

Breech Presentation↗
PubMed1998

[External fetal version from breech presentation to cephalic presentation: modifying factors, reliability and risks].

External cephalic version (ECV) was performed in 524 single pregnancies. The version was successful in 38.4%. Success is mainly influenced by parity, quantity of amniotic fluid and maternal weight. An emergency cesarean section was necessary in 0.6% because of fetal bradycardia. Compared to controls the ECV was not associated with the increase of a premature rupture of membranes, complications with umbilical cord or transfer of the child to the paediatric department. Also there was no difference in the pH or Apgar-ranges. One fetal death was diagnosed 17 days after ECV, the reason therefore remained unclear. There are existing a few other reports with similar cases. We conclude that ECV is a appropriate trial to convert the fetus into cephalic presentation, but because of possible complications precautions must be taken, e.g. that means to carry out the trial under conditions which allow immediate cesarean section and a frequent follow up of the woman until delivery.

Adult↗
PubMed1996

[Fetal version as ambulatory intervention].

The external cephalic version (ECV) of the fetus at term reduces the maternal and fetal risks of intrapartum breech presentation and Caesarean delivery. Since 1986 over 800 external cephalic versions were performed in the outpatient Department of Obstetrics and Gynaecology of the Städtische Frauenklinik Stuttgart. 60.5% were successful. NO severe complications occurred. Sufficient amniotic fluid as well as the mobility of the fetal breech is a major criterion for the success of the ECV. Management requires a safe technique for mother and fetus. This includes ultrasonography, elektronic fetal monitoring and the ability to perform immediate caesarean delivery as well as the performance of ECV without analgesicas and sedatives. More than 70% of the ECV were successful without tocolysis. In unsuccessful cases the additional use of tocolysis improves the success rate only slightly. Therefore routine use of tocolysis does not appear necessary. External cephalic version can be recommended as an outpatient treatment without tocolysis.

Adult↗
PubMed1977

Value of external version in fetal malpresentation in combination with use of ultrasound.

During 1969--1974 six hundred and forty-nine external versions were attempted during the last trimester on 491 mothers with fetal malpresentation. The procedure was monitored with ultrasound in 1969--1974. Most of attempts (70.0%) were made during the 32nd-36th weeks. The final version rate after one or more attempt was 76.2%, being lower (67.0%) in nulliparous than parous women (84.6%). The incidence of breech presentation at birth decreased from 4.5 to 2.9% (p less than 0.001). The most serious complication was one premature labor but the infant survived. The perinatal mortality was 2.0% and, after excluding abnormal infants, 0.8%. The combination of external version and the use of ultrasound is a safe method which avoids hazardous vaginal breech delivery and is recommended in obstetric practice.

Apgar Score↗
PubMed1990

An altered IGF-I receptor is present in human leukemic cells.

We have characterized and analyzed IGF-I- and insulin-stimulated cell growth, receptor binding, and autophosphorylation in the human leukemic cell line HL-60. IGF-I-stimulated cell growth occurred at low (5 ng/ml) and insulin stimulated only at high (500 ng/ml) concentrations. Binding of 125I-IGF-I to partially purified plasma membrane proteins followed the characteristics of IGF-I receptor binding. 125I-IGF-I binding, as determined by chemical cross-linking, occurred to a 145-kDa protein. IGF-I, as well as insulin, stimulated the autophosphorylation of a 105-kDa band (pp105), but we could not detect a 95-kDa band corresponding to the known molecular mass of the IGF-I and insulin receptor beta-subunits. Phosphorylation of pp105 followed the dose-response characteristics of the IGF-I receptor. The phosphorylation of pp105 occurred at tyrosine and threonine, and the pattern of HPLC tryptic peptide maps showed marked differences when compared with that of a phosphorylated insulin receptor beta-subunit. Enzymatic deglycosylation of pp105 resulted only in a slight reduction of the molecular weight. These data suggest that pp105 is the beta-subunit of an IGF-I receptor variant with a higher molecular weight, similar to that found in fetal tissue. The HL-60 cell may acquire, at least in part, malignant growth characteristics through reexpression of the fetal version of the IGF-I receptor.

Cell Division↗
PubMed1995

Fetal acoustic stimulation as an adjunct to external cephalic version.

OBJECTIVE: To evaluate fetal acoustic stimulation (FAS) as an adjunct to external cephalic version in a midline fetal spine presentation. STUDY DESIGN: Breech presentation in a woman presenting for attempted version at 37 weeks' gestation with a fetus in a midline position and the spine anterior is difficult to convert to a vertex. An evaluation of FAS to assist in repositioning the fetus in a more spine lateral position was carried out. Patients with a failed version attempt and a midline breech presentation were enrolled in the study. The patient served as her own control. If that attempt failed, an electrolarynx device was used to produce a one- to three-second stimulus, and then another version attempt was made. RESULTS: Sixteen patients were enrolled. Prior to FAS, 0/16 fetuses were successfully turned. FAS altered the position in 100% of patients from spine midline to lateral. After FAS, 15/16 (94%) were successfully converted to vertex presentation. The one patient whose fetus failed to convert also failed her second version attempt (P < .0005). CONCLUSION: FAS may improve the opportunity for successful external cephalic version in the properly selected candidate with a fetus in a midline position with the spine anterior.

Acoustic Stimulation↗
PubMed1990

Development and application of a simple expert system for the interpretation of the antepartum fetal heart rate tracings (version 88/2.29).

A simple expert system is developed for the interpretation of antepartum fetal heart rate tracings. The perinatal expert chose to use the phrase 'Fetal Reserve' to describe what the cardiotocogram is indirectly measuring. Our analysis program gives numerical values to each CTG such as 5, 4, 3, 2.5, 2 and 1 corresponding to the fetal reserve conditions of good, satisfactory, probably satisfactory with uncertainty, borderline, decreased, and critical respectively. This study consists of 33 normal pregnancies with normal outcome. Each patient is followed by our computerized system biweekly from the 28th to the 38th gestational week and weekly there after. The expert system's decision for 28th, 30th, 32nd, 34th, 36th, 38th, 39th and 40th gestational weeks were 3.3 +/- 1.0, 3.8 +/- 0.7, 3.8 +/- 1.0, 4.1 +/- 0.9, 4.1 +/- 0.7, 3.6 +/- 1.0, 4.2 +/- 1.0, 3.8 +/- 0.9 and 3.4 +/- 1.2, respectively. In this study, we have used confusion matrix to determine the normal, security, and danger zones according to the perinatal expert and the expert system and the discriminatory power of the system is found to be highly significant statistically (Q = 221). We also showed that the passive test (non-stress test) in normal pregnancies has demonstrated false positive results in 4.2 and 9.3% of the cases according to the evaluations of the perinatal expert and the expert system, respectively.

Expert Systems↗
PubMed1991

The validation of a computerized system for the interpretation of the antepartum fetal heart rate tracings (version 89/2.34).

We have developed a knowledge-based system for the interpretation of the antepartum fetal heart rate tracings. This study consists of four groups of patient: (1) 49 normal pregnancies with a normal perinatal outcome; (2) 13 normal pregnancies with abnormal perinatal outcome; (3) 33 high-risk pregnancies with abnormal perinatal outcome; and (4) 16 high-risk pregnancies with normal perinatal outcome. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of our expert system (version 89/2.34) were estimated to be 60.0, 85.7, 75.0 and 75.0%, respectively. When the normal pregnancies with abnormal outcome and the high-risk pregnancies with normal outcome were excluded from the population, sensitivity, specificity, PPV and NPV were calculated to be 57.7, 82.9, 68.2 and 75.6%, respectively (corrected values). The prevalance of abnormal outcome for this study was 41.7%.

Cardiotocography↗
PubMed1996

Computerized analysis of fetal heart rate changes after antepartum external cephalic version.

OBJECTIVE: To assess the fetal heart rate (FHR) changes following external cephalic version using a computerized FHR monitor. STUDY DESIGN: We performed 116 external cephalic versions on 106 pregnant women at 36-40 weeks' gestation. Tocolysis (magnesium sulfate) was given to 39 patients (34%). Computerized FHR monitoring was performed for 20-30 minutes before and for 20-30 minutes after the procedure. In addition, we analyzed the results of the FHR tracing obtained during the first 10 minutes following the procedure. RESULTS: External cephalic version was successful in 40% of the patients. In the group of patients who were not treated with magnesium sulfate, FHR variation and the number of accelerations per 10 minutes were significantly reduced during the first 10 minutes following the procedure as compared with those factors on the FHR tracings obtained before or 20-30 minutes following the procedure (P < .05). In the group of patients who were treated with magnesium sulfate, FHR variation and the number of accelerations per 10 minutes were significantly reduced before and 10 minutes after the procedure as compared with the FHR tracings obtained 20-30 minutes following the procedure (P < .05). In both groups the basal FHR was significantly lower during the first 20-30 minutes following the procedure (P < .05). FHR decelerations were observed following the procedure in only two patients. None of the 106 fetuses had a low Apgar score or were admitted to the neonatal intensive care unit. CONCLUSION: External cephalic version appears to be safe for the mother and fetus, although transient FHR changes may occur following the procedure.

Adult↗
PubMed1992

External cephalic version and daily post-versional maternal self-assessment of fetal presentation. A prospective study.

External cephalic version (ECV) using tocolysis is a widely recognized low-risk intervention in cases of breech presentation, particularly in areas where resources are scarce and the perinatal mortality is high in vaginal breech deliveries. In such a setting, pregnant women were trained to make regular self-assessments of the presenting fetal part after ECV in order to detect spontaneous reversions to breech presentation. It was found that such maternal involvement could significantly improve the final results of ECV.

Breech Presentation↗